Clinical genitourinary cancer最新文献

{"title":"Effect of NSAID Consumption on Renal Cell Carcinoma Prognosis: A Population-Based Study","authors":"Ilkka Kemppinen,&nbsp;Antti Pöyhönen,&nbsp;Priit Veskimäe,&nbsp;Thea Veitonmäki,&nbsp;Teuvo Tammela,&nbsp;Teemu J. Murtola","doi":"10.1016/j.clgc.2025.102311","DOIUrl":"10.1016/j.clgc.2025.102311","url":null,"abstract":"<div><h3>Objective</h3><div>The objective is to study the effect of NSAID consumption on renal cell carcinoma prognosis.</div></div><div><h3>Methods</h3><div>In retrospective cohort study patients diagnosed with renal cell carcinoma (RCC) between 1995 and 2015 (<em>n</em> = 7492) were divided into subgroups based on their NSAID use. Multivariate adjusted analyses were performed using cox's regression model to evaluate hazard ratio for RCC mortality. Analyses were conducted separately for acetylsalicylic acid (ASA), COX-2 selective inhibitor (COXIB), and NSAID (including ASA and COXIB) users.</div></div><div><h3>Results</h3><div>Any NSAID consumption prior to the diagnosis of RCC exhibits a slightly elevated mortality rate compared to individuals who do not consume NSAIDs (HR 1.08, 95% CI 1.00-1.16). Pre- and postdiagnostic ASA and KOKSIB use, as well as postdiagnostic NSAID, ASA, and COXIB use, weren't associated with RCC mortality. Among women, NSAID use elevated RCC mortality both prior to the diagnosis (HR 1.21, 95% CI 1.08-1.36, <em>P</em> = .005) and after the diagnosis (HR 1.15, 95% CI 1.05-1.29, <em>P</em> = .046).</div></div><div><h3>Conclusion</h3><div>Prediagnostic NSAID consumption slightly elevated RCC mortality. Among women, both pre- and postdiagnostic NSAID use is associated with heightened RCC mortality.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102311"},"PeriodicalIF":2.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Urinary Tract Persistence or Progression in Patients Treated With Immunotherapy for Advanced Urothelial Carcinoma","authors":"Pierre-Etienne Gabriel ,&nbsp;Hélène Gauthier ,&nbsp;Evanguelos Xylinas ,&nbsp;Jean-François Hermieu ,&nbsp;François Desgrandchamps ,&nbsp;Christophe Hennequin ,&nbsp;Stéphane Culine ,&nbsp;Alexandra Masson-Lecomte ,&nbsp;Clément Dumont","doi":"10.1016/j.clgc.2025.102312","DOIUrl":"10.1016/j.clgc.2025.102312","url":null,"abstract":"<div><h3>Purpose</h3><div>Emerging therapies including anti-PD-(L)1 immunotherapy have changed paradigms of treatment and improved oncological outcomes of advanced/metastatic urothelial carcinoma (mUC) patients. An emerging challenge in this setting is the management of isolated urinary tract persistence or progression (IUTP) of primary urothelial tumor despite stability or response of metastatic disease to immunotherapy.</div></div><div><h3>Methods</h3><div>This retrospective monocentric study included all patients treated with single-agent anti-PD-(L)1 for mUC between August 2015 and October 2023. Patients were divided in cohorts of interest depending on primary UC site (lower or upper tract) and previous surgery at the time of immunotherapy initiation. Incidence of IUTP was analyzed in a competitive-risk fashion.</div></div><div><h3>Results</h3><div>Overall,107 patients with mUC and no previous surgical treatment of primary tumor treated with immunotherapy were at risk of local progression. Among 65 mUC with an untreated bladder primary site, the cumulative incidence rate of IUTP in patients with nonprogressive metastatic disease on immunotherapy was 21.4% and 42.7% at 1 and 2 years, respectively. In responders, half of IUTP were nonmuscle invasive;5 patients, including all 3 with NMIBC, remained free of distant progression after a median follow-up of 12.7 (4.6-41.2) months. In mUTUC, 2 out of 18 patients (11.1%) experienced isolated primary site progression and underwent radical nephroureterectomy, with one patient remaining free of distant progression over 1 year.</div></div><div><h3>Conclusions</h3><div>These preliminary results show high incidence of IUTP as a progression pattern in mUC patients with clinical benefit of immunotherapy for mUC, highlighting the interest of monitoring the primary tumor and considering local treatment in selected cases, with promising oncological outcomes.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102312"},"PeriodicalIF":2.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic Pure Seminomas With Early Relapse: Prognostic Roles of High Dose Chemotherapy and Surgery of Residual Disease","authors":"Lucile Duval ,&nbsp;Benoît Allignet ,&nbsp;Christine Chevreau ,&nbsp;Gwenaelle Gravis ,&nbsp;Camille Mazza ,&nbsp;Marine Gross-Goupil ,&nbsp;Brigitte Laguerre ,&nbsp;Patrice Peyrat ,&nbsp;Floriane Izarn ,&nbsp;Anna Patrikidou ,&nbsp;Aude Fléchon","doi":"10.1016/j.clgc.2025.102310","DOIUrl":"10.1016/j.clgc.2025.102310","url":null,"abstract":"<div><h3>Introduction</h3><div>Metastatic seminomatous germ cell tumors (mSGCT) are a rare form of cancer. Few studies focused on early relapse (&lt;12 months) after first-line chemotherapy (ChT). We aimed to retrospectively evaluate the impact of salvage retroperitoneal lymph node dissection (RPLND) and high-dose ChT with hematopoietic stem cell transplantation (HDCT-HSCT) in mSGCT patients in a situation of early relapse.</div></div><div><h3>Methods</h3><div>Ninety-one mSGCT patients treated between 2005 and 2023 in 7 French expert centers for an early recurrence after an initial favorable response to first-line ChT were retrospectively included. Patient clinical characteristics, progression-free survival after first relapse (PFS) and overall survival (OS) were evaluated. We also assessed the role of HDCT-HSCT as first salvage treatment, and the impact of complementary RPLND after salvage ChT.</div></div><div><h3>Results</h3><div>After a median follow-up of 56 months, 3-year PFS and OS rates were 77.6% (95% CI, 68.3-88.1) and 88.4% (95% CI, 81.0-96.4), respectively. HDCT-HSCT was not associated with longer PFS or OS compared to standard-dose second-line ChT. In contrast, patients who underwent RPLND after salvage ChT demonstrated significantly longer PFS (at 3-years: 97.1% vs. 63%; HR 0.15; 95% CI, 0.03-0.65; <em>P</em> = .012) and a notable trend towards improved OS (at 3-years: 97.0% vs. 81.8%; HR 0.15; 95% CI, 0.02-1.23; <em>P</em> = .078).</div></div><div><h3>Conclusion</h3><div>RPLND after salvage treatment could be associated with improved PFS and OS in mSGCT patients with first-year relapse. However, the retrospective nature of the study limits causal inference, and prognostic factors influencing treatment selection should be further explored. Identifying subpopulations that might benefit from HDCT-HSCT is warranted.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102310"},"PeriodicalIF":2.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium-Glucose Cotransporter 2 (SGLT2) as a Potential Biomarker and Target in Papillary Renal Cell Carcinoma","authors":"Erman Akkus ,&nbsp;Emre Yekedüz ,&nbsp;Yüksel Ürün","doi":"10.1016/j.clgc.2025.102314","DOIUrl":"10.1016/j.clgc.2025.102314","url":null,"abstract":"<div><h3>Background</h3><div>SGLT2 is selectively expressed in the human kidney. SGLT2 inhibitors have markedly changed diabetes, heart failure, and kidney disease treatment, and are under investigation in cancer. However, the role of SGLT2 in papillary renal cell carcinoma (pRCC) is not known.</div></div><div><h3>Methods</h3><div>We investigated the SGLT2 gene expression, associated clinical-molecular features, and overall survival (OS) in pRCC. The Cancer Genome Atlas Program and Gene Expression Omnibus data were utilized. mRNA expression z-scores of the SGLT2 gene relative to normal samples (log-RNASeqV2-RSEM, threshold ± 2) were analyzed (low, unaltered, high expression).</div></div><div><h3>Results</h3><div>273 patients were involved. As per mRNA expression, 180 patients (66%) had low, and the remaining had unaltered expression. High correlation (<em>r</em> &gt; 0.6) with SGLT2 was observed in <em>IRX5, STRIP2, LINC00899, SATB2-AS1, FOXC1, IRX3, SLC22A8, SH3BP5</em> genes (<em>P</em> &lt; .001,<em>q</em> &lt; 0.001 for all) and with the <em>HIF-2α</em> (r:0.43, <em>P</em> &lt; .001,<em>q</em> &lt; 0.001). Tumor mutational burden (<em>P</em> = .365) and aneuploidy scores (<em>P</em> = .976) did not differ, however, among the genes with the highest alteration frequency, <em>SETD2</em> alterations (15.63% vs. 1.07%, <em>P</em> &lt; .00, <em>q</em> = 0.046) were more frequent in the unaltered-expression group. Differential protein expression analysis showed highly separated proteins (ERBB2, AR, MAPK14, VHL, TGM2 in the low and SHC1, SQSTM1, MYH14, and CDH1 in the unaltered group). The median OS has not reached the median in both groups [Hazard Ratio(HR) for the unaltered group:2.658, 95% Confidence Interval(CI):1.401-5.043, <em>P</em> = .003]. SGLT2 expression remained a significant prognostic factor in multivariable analysis [HR:2.446 (95%CI: 1.199-4.990), <em>P</em> = .014].</div></div><div><h3>Conclusions</h3><div>This study reveals the first data that SGLT2 might have a role in pRCC as a pathogenic factor and biomarker. Confirmatory mechanistic studies are needed.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102314"},"PeriodicalIF":2.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Treatment Patterns and Outcomes in Patients With Bacillus Calmette-Guérin–Unresponsive High-Risk Non–Muscle-Invasive Bladder Cancer: A Multicountry Medical Chart Review","authors":"Girish S. Kulkarni ,&nbsp;Thomas Guzzo ,&nbsp;Philip H. Abbosh ,&nbsp;William C. Huang ,&nbsp;Neal Shore ,&nbsp;Zachary Smith ,&nbsp;Ho Kyung Seo ,&nbsp;Ja Hyeon Ku ,&nbsp;Jean-Benoit Paradis ,&nbsp;Romain Mathieu ,&nbsp;Mathieu Roumiguié ,&nbsp;Abhishek Srivastava ,&nbsp;Carly Rodriguez ,&nbsp;Claire M. Fox ,&nbsp;Ekta Kapadia ,&nbsp;Mehmet Burcu ,&nbsp;Joost L. Boormans","doi":"10.1016/j.clgc.2025.102313","DOIUrl":"10.1016/j.clgc.2025.102313","url":null,"abstract":"<div><h3>Introduction</h3><div>Treatment patterns for patients with bacillus Calmette-Guérin (BCG)–unresponsive high-risk non–muscle-invasive bladder cancer (NMIBC) who are ineligible for or decline radical cystectomy (RC) are inconsistently reported. We retrospectively described demographic, clinical, and treatment characteristics for these patients and assessed their clinical outcomes.</div></div><div><h3>Patients and Methods</h3><div>Medical charts of patients with BCG-unresponsive high-risk NMIBC (carcinoma in situ [cohort A] or T1/high-grade Ta [cohort B]) who were ineligible for or declined RC documented between January 1, 2011, and December 31, 2018, at 15 academic centers were reviewed. Primary objectives were to characterize demographic, clinical, and nonsurgical treatment characteristics. Secondary objectives included assessing real-world progression-free survival (rw-PFS) from muscle-invasive/metastatic disease, rw-PFS from worsening grade or stage, real-world complete response rate (rw-CRR) in cohort A, real-world event-free survival (rw-EFS) from high-risk NMIBC in cohort B, and overall survival.</div></div><div><h3>Results</h3><div>The study included 129 patients (cohort A, n = 57; cohort B, n = 72). Median age was 72.0 years (interquartile range, 64.0-80.0). Most patients were male (72.1%) and current/former smokers (69.8%). Median follow-up was 32.1 months (interquartile range, 20.7-47.6). BCG rechallenge with or without interferon-α (63.6%) was the most commonly utilized first nonsurgical therapy, followed by intravesical mitomycin C with or without electromotive drug administration or thermochemotherapy (15.5%), and intravesical valrubicin (10.9%); among those who received BCG rechallenge alone, 54.8% later received a non-BCG therapy in ≥ 2 subsequent treatments. 36-month rate for rw-PFS from muscle-invasive/metastatic disease was 73.5%, 66.8% for rw-PFS from worsening grade/stage, and 82.5% for overall survival. In cohort A, 6-month rw-CRR was 22.2%. In cohort B, 36-month rw-EFS rate from high-risk NMIBC was 50.2%.</div></div><div><h3>Conclusion</h3><div>After BCG-unresponsive disease, most patients with high-risk NMIBC received BCG rechallenge with or without other therapies, and &gt; 25% experienced disease progression within the first 3 years. Effective bladder-sparing options for BCG-unresponsive NMIBC are needed.</div></div><div><h3>Clinical trial registration</h3><div>N/A.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102313"},"PeriodicalIF":2.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Failure After Definitive Trimodality Therapy for Muscle-Invasive Bladder Cancer","authors":"Nikhil V. Kotha ,&nbsp;Abhishek Kumar ,&nbsp;Paul Riviere ,&nbsp;Tyler J. Nelson ,&nbsp;Edmund M. Qiao ,&nbsp;Amirali Salmasi ,&nbsp;Rana R. McKay ,&nbsp;Jason A. Efstathiou ,&nbsp;Brent S. Rose ,&nbsp;Tyler F. Stewart","doi":"10.1016/j.clgc.2024.102229","DOIUrl":"10.1016/j.clgc.2024.102229","url":null,"abstract":"<div><h3>Background</h3><div>Real-world outcomes, especially patterns of failure, are limited for patients with muscle-invasive bladder cancer (MIBC) treated with trimodality therapy (TMT). We aim to evaluate patterns of failure after TMT for MIBC in a typical heterogeneous population.</div></div><div><h3>Methods</h3><div>In the national Veterans Affairs database, patients with urothelial histology, MIBC (T2-4a/N0-3/M0) who underwent definitive intent TMT between 2000-2018. Successful TMT was defined as ≥ 50% definitive radiation dose and ≥ 1 cycle chemotherapy. Endpoints of any recurrence, metastatic (nonbladder) recurrence (MR), and local (bladder) recurrence (LR) evaluated in multivariable Fine-Gray models. Times to recurrence calculated from radiation start date.</div></div><div><h3>Results</h3><div>In 347 patients with MIBC treated with TMT, 65% of patients were deemed ineligible for surgery while 35% were surgically eligible but elected for TMT. Median follow-up time was 77 months. Median overall survival was 32.4 months (95% CI: 28.2-36.7). 154 (44%) patients had no recurrence. 130 (37%) patients developed MR, median time 9.9 months. 117 (34%) patients developed LR, median time 8.7 months. In multivariable models, lymph node positive (LN+) disease (HR:3.31, 95% CI: 1.45-7.55, <em>P</em> &lt; .01) and pretreatment hydronephrosis (HR:1.62, 95% CI:1.11-2.36, <em>P</em> = .01) were associated with higher rates of MR. No patient, tumor, or treatment variables were associated with LR.</div></div><div><h3>Conclusions</h3><div>Across a multi-institutional and heterogeneous population, TMT is an effective treatment for many real-world patients with MIBC. However, a notable proportion of patients develop MR and/or LR which emphasizes the need for post-treatment surveillance and improved treatment pathways. Identified high risk features (LN+ disease, pretreatment hydronephrosis) and other markers should be further investigated to delineate the patients at high risk of TMT failure who therefore may potentially benefit from augmented treatment, such as additional systemic therapy.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102229"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, Diagnostic and Therapeutic Framework of mHSPC and nmCRPC: A Multidisciplinary Consensus Project of the Italian Society for Uro-Oncology (SIUrO)","authors":"Rolando Maria D'Angelillo ,&nbsp;Orazio Caffo ,&nbsp;Nicolò Borsellino ,&nbsp;Giampiero Cardone ,&nbsp;Giuseppe Ferdinando Colloca ,&nbsp;Giario Natale Conti ,&nbsp;Marzia Del Re ,&nbsp;Stefano Fanti ,&nbsp;Barbara Alicja Jereczek-Fossa ,&nbsp;Alberto Lapini ,&nbsp;Giovanni Luigi Pappagallo ,&nbsp;Tommaso Prayer Galetti ,&nbsp;Sergio Bracarda","doi":"10.1016/j.clgc.2024.102292","DOIUrl":"10.1016/j.clgc.2024.102292","url":null,"abstract":"<div><div>The recent evidences provided in metastatic hormone sensitive prostate cancer (nmHSPC) and in nonmetastatic castration resistant (nmCRPC) introduced the possibility to adopt Androgen Receptor Signaling inhibitor (ARSi) alone (both settings) or with chemotherapy (in mHSPC). In daily clinical practice there are some opening questions regarding the inclusion of next generation imaging, mainly PSMA-PET, how integrate local treatment as radiotherapy, how to select patients or drugs in a multiple-choice scenario, and how to manage patients with comorbidities and polypharmacy. These issues led the Italian Society for Uro-Oncology (SIUrO) to develop a consensus project involving all of the most important Italian scientific societies engaged in the multidisciplinary and multiprofessional management of the disease. This paper describes the items and statements approved, with the aim to support clinicians in managing metastatic hormone sensitive and nonmetastatic castration resistant prostate cancer patients.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102292"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjuvant Immunotherapy in High-Risk Muscle-Invasive Urothelial Cancer: An Updated Meta-Analysis of Randomized Controlled Trials","authors":"Isadora Mamede ,&nbsp;Caroliny Silva ,&nbsp;Ana Caroline Alves ,&nbsp;Joao Pedro Oliveira ,&nbsp;Melissa Maia ,&nbsp;Caio Dabbous de Liz ,&nbsp;Audrey Cabral de Oliveira","doi":"10.1016/j.clgc.2024.102288","DOIUrl":"10.1016/j.clgc.2024.102288","url":null,"abstract":"<div><h3>Introduction</h3><div>Neoadjuvant cisplatin-based chemotherapy followed by radical surgery is the standard treatment for muscle-invasive urothelial carcinoma (MIUC). The Checkmate-274 and AMBASSADOR trials have demonstrated improvements in disease-free survival (DFS) with adjuvant immunotherapy. Consequently, this meta-analysis aimed to assess the effectiveness of strategies involving checkpoint inhibitors in managing high-risk MIUC.</div></div><div><h3>Patients and Methods</h3><div>We searched PubMed, Embase, Cochrane, ClinicalTrials.gov, EAU24, and ASCO GU abstracts for randomized controlled trials (RCTs) comparing adjuvant PD-1 and PD-L1 inhibitors against control (placebo or observation) for MIUC. Outcomes included DFS, grade ≥3 adverse events (AEs), and overall survival (OS). Heterogeneity was assessed using I2 statistics, employing a random-effects model for analysis.</div></div><div><h3>Results</h3><div>In a cohort of 2220 patients from three RCTs, 1,113 (50.14%) underwent adjuvant immunotherapy. This treatment significantly increased DFS (HR 0.76; 95% CI, 0.65-0.90; <em>P</em> &lt; .01), particularly in lower tract tumors (HR 0.71; 95% CI, 0.56-0.91; <em>P</em> &lt; .01). No substantial DFS improvement surfaced in the upper tract subgroup (<em>P</em> = .28) (p-interaction = .01). PD-L1 status (p-interaction = .83) and previous neoadjuvant chemotherapy (p-interaction = .11) did not significantly affect outcomes. However, immunotherapy correlated with higher grade ≥3 AEs (RR 1.47; <em>P</em> &lt; .01), with no notable difference in OS (<em>P</em> = .07).</div></div><div><h3>Conclusions</h3><div>Adjuvant PD-1/PD-L1 inhibitors notably enhance MIUC DFS, particularly in lower tract tumors, regardless of PD-L1 status. These findings support immunotherapy, especially anti-PD1, as a valuable adjuvant treatment strategy for high-risk MIUC patients.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102288"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A French Multicenter Real-Life Study on the Biological and Clinical Parameters Associated With Response to Immune Checkpoint Inhibitors (ICIs) in Second-Line Treatment of Advanced Urothelial Carcinoma: Impact of Antibiotics Administration at the Time of ICIs Initiation","authors":"Pierre Grassi ,&nbsp;Werner Hilgers ,&nbsp;Romain Boissier ,&nbsp;Alexandre Bertucci ,&nbsp;Damien Bruyat ,&nbsp;Florence Duffaud ,&nbsp;Faustine Enoch ,&nbsp;Philippe Rochigneux ,&nbsp;Julien Mancini ,&nbsp;Jean-Laurent Deville","doi":"10.1016/j.clgc.2024.102283","DOIUrl":"10.1016/j.clgc.2024.102283","url":null,"abstract":"<div><h3>Background</h3><div>After failure of first-line chemotherapy, standard of care for advanced urothelial cancer (aUC) is immune checkpoint inhibitors (ICIs) targeting PD-1/PD-L1 pathway. Several prognostic models (Bajorin and Bellmunt scores) have been evaluated, but only in the context of chemotherapy.</div></div><div><h3>Objective</h3><div>To study whether the variables in these scores and new emerging clinical and biological criteria have an impact on the probability of objective response in aUC treated with ICIs in 2nd-line setting and beyond.</div></div><div><h3>Materials and methods</h3><div>Between October 2016 and March 2023, we included 168 patients treated with ICIs in 2nd-line setting or more in 2 French centers. Variables of interest were selected after a literature review and collected retrospectively. Analyses used log-rank test and multivariate models (binary logistic and Cox regressions).</div></div><div><h3>Results and limitations</h3><div>Median age at diagnosis was 68 years. Patients presented with bladder tumors in 73.8% and upper urinary tract tumors in 26.2%. 63.7% of patients had received only one line of chemotherapy before ICIs<strong>.</strong> Median follow-up after starting ICIs was 8.9 months.</div><div>The variables statistically associated with objective response were:</div><div>− The presence of locally advanced or lymph node-only disease compared with visceral involvement (adjusted Odds Ratio 0.19, 95% confidence interval [0.06-0.55], <em>P</em> = .002) and bone-only involvement (aOR 0.22 [0.08-0.64], <em>P</em> = .005)</div><div>− The absence of antibiotic therapy the month before/after ICIs initiation (aOR 0.31 [0.12-0.84], <em>P</em> = .021).</div><div>Limitations included retrospective design and small number of patients included.</div></div><div><h3>Conclusion</h3><div>This real-life study from 2 French centers found a higher likelihood of objective response:</div><div>− In the absence of antibiotic therapy at ICIs initiation:</div><div>− In locally advanced or lymph node-only disease, in contrast to visceral or bone-only disease.</div><div>Our results suggest that negative impact of antibiotic therapy on the response to ICIs needs to be further investigated to optimize the management of these patients.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102283"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activity of Platinum Chemotherapy in Men With Prostate Cancer With and Without DNA Damage Repair Mutations","authors":"Stephanie Lakritz ,&nbsp;Andrew Nicklawsky ,&nbsp;Vida Alami ,&nbsp;Manish Kohli ,&nbsp;Chris Moskaluk ,&nbsp;Greg Riedlinger ,&nbsp;Bodour Salhia ,&nbsp;Eric A. Singer ,&nbsp;Abdul Rafeh Naqash ,&nbsp;Ken Nepple ,&nbsp;Stephen Edge ,&nbsp;Zin Myint ,&nbsp;Jill Kolesar ,&nbsp;Nabil Adra ,&nbsp;Thomas Flaig ,&nbsp;Laura S. Graham","doi":"10.1016/j.clgc.2024.102293","DOIUrl":"10.1016/j.clgc.2024.102293","url":null,"abstract":"<div><h3>Introduction</h3><div>Alterations in homologous recombination repair (HRR) genes occur in 20%-30% of men with metastatic castration-resistant prostate cancer (mCRPC) which may increase sensitivity to platinum chemotherapy. Specifically, exceptional responses to platinum chemotherapy have been reported among patients with <em>BRCA</em> mutations. This study aimed to evaluate the efficacy of platinum chemotherapy in patients with mCRPC with and without HRR.</div></div><div><h3>Patient and Methods</h3><div>In this retrospective, multi-institution series, we analyzed patients with mCRPC to assess response to platinum-containing chemotherapy based on HRR alteration status. Outcome measures were prostate specific antigen (PSA)50 response rate (percentage of patients achieving at least a 50% decline in PSA from baseline), overall survival (OS) and progression-free survival (PFS).</div></div><div><h3>Results</h3><div>From 1999 to 2020, 24 patients with mCRPC who received platinum chemotherapy were included with 7 patients analyzable for PSA outcomes. HRR alterations were found in 19 out of 24 patients (79.2%) with mutations recognized in 11 different HRR genes. Patients with a HRR alteration achieved a PSA50 response rate of 20% (1 out of 5) after platinum chemotherapy compared to 50% (1 out of 2) in patients without a HRR mutation. No difference in OS or PSA PFS was detected among patients with <em>BRCA1/2</em> mutations compared to HRR alterations other than <em>BRCA1/2</em> and patients without HRR alterations.</div></div><div><h3>Conclusion</h3><div>In patients with mCRPC, we did not find a statistical difference in anti-tumor activity after receiving platinum chemotherapy among patients harboring a pathogenic HRR alterations compared to patients without a HRR alteration. Additionally, we were unable to detect an association between <em>BRCA1/2</em> mutation status and response to platinum chemotherapy. Platinum chemotherapy, however, had clinically meaningful activity in a subset of patients regardless of HRR alteration status. Additional studies are warranted using genomic data to predict sensitivity to platinum chemotherapy.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102293"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}